Separate Beds: A History of Indian Hospitals in Canada, 1920s–1980s by Maureen K. Lux (review)

In this short volume, Maureen Lux weaves a contextual narrative of several decades of the history of Indian Hospitals within the changing landscape of Canada's national health-care system. It is a text that is best read in small doses to digest and internalize. One can quickly become absorbed in the myriad of details and neglect the broader message of how elements of our social fabric—the construction of the welfare state within a liberal democracy and the creation of national health care—have had distinct and disruptive trajectories, contributing to the greater exclusion and inequality of Aboriginal peoples.

Lux states as her overall objective the demonstration of how two stories became separate ones—improving health care of Canadians and the opposite case within Aboriginal communities. To do so, she draws upon the narratives of individuals in these Aboriginal communities, including their experience in "southern hospitals" and in urban settings, teasing out what she describes as embodied resistance. This thematic approach integrates Aboriginal communities, residential schools, major cities, and particularly, sanatoria. Indeed, the history of tuberculosis and the development of alternate means to research, control, and eradicate the disease became inextricably intertwined in these narratives of exclusion and marginalization.

I focus on this latter aspect to illustrate the volume's richness. Statistical data were a growing influence in the classification and evaluation of the treatment of tuberculosis. Along with their use, the oft-competing interests and priorities of the Canadian Tuberculosis Association, various provincial bodies and federal agencies such as the Indian Health Service, resulted in the shift from a focus on tuberculosis to a much different focus on the "Indian problem." This Indian problem frequently surfaced in parallel with initiatives after World War I to treat veterans, the questionable and experimental treatment of both white and Aboriginal patients, and the decision in later decades to develop segregated institutions to bring the disease under control. Yet, we learn (again) that the statistics reporting declining rates of infection in the white population, in contrast with seemingly growing rates amongst Aboriginal peoples, were incomplete and faulty. The conflicting and conflicted policies and paternalistic efforts of federal and provincial bureaucracies, religious organizations, and publicpolicy groups led to on-going tendencies to translate benevolence and compassion into assimilation. Within this side of the story, the voices of Aboriginal peoples were more frequently absent, struggling to be heard above the other voices and seeking standing within broader debates of national values, social democracy, and treaty rights. These latter voices and words, such as those of David Melting Tallow, force us to confront that the legacy of residential schools was reinforced and compounded by treatments in Indian hospitals. Similarly, we see the compelling images from National Film Board narratives of the solving of the so-called Indian problem through assimilation and relocation to urban settings. While not perhaps the author's intention, the 1950s photos by Yousuf Karsh convey what could and should, perhaps, have been interpreted as an effort to draw attention to and correct accepted narratives by transmitting the underlying reality, "loneliness and frustration" of those institutionalized within Indian hospitals (123). The weaving together of all of these themes challenges and motivates the reader to revisit and re-think a phrase or paragraph to grasp this nuanced history and its legacy.

There are nevertheless areas that are not as convincing. The brief mention of Foucault in the introduction does not sit well with the remainder of the text. Indeed, Foucault does not even merit an entry in the index and the comments seem to ignore recent interpretations of what he truly was examining in his work on institutions, prisons, and insanity. At times, Lux tries a trifle too hard to point out just how biased, racist, and paternalistic were the non-Aboriginal protagonists with little room left for the reader to make a judgement...